Acute renal failure directly caused by hemolysis associated with transurethral resection of the prostate

Hung, Chung‐Lieh; Wu, Chun–Te; Yang, Stone; Chen, Han Hsian; Lin, John Son

doi:10.1016/s0090-4295(01)01477-7

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…Besides that, a study by Hawary et al (2009) supported acute renal failure as a sign and symptom of TURP syndrome. Moreover, haemolysis blood also leads to kidney failure and renal vasoconstriction (Hung et al, 2002). Eventually, this renal metabolic disturbance leads to lower extremities oedema as mentioned by participants in this study.…”

Section: Discussionsupporting

confidence: 49%

“…During the study in phase one, participants addressed hyperkalemia in the laboratory findings of a patient who had TURP syndrome. Moreover, haemolysis blood also leads to kidney failure and renal vasoconstriction (Hung et al, 2002). Electrocardiogram assessment will present tall, peaked T waves, PR prolongation, decrease in amplitude of P wave, QRS widening and arrhythmias.…”

Section: Renal and Metabolic Disturbances A Natremiamentioning

confidence: 99%

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Nursing assessment of TURP syndrome: a pilot study

Subrata

Istanti

Kesetyaningsih

2018

Int J of Uro Nursing

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How can the signs and symptoms of transurethral resection prostate (TURP) syndrome be identified by nurses? This study aimed to develop a nursing instrument to assess TURP syndrome. TURP syndrome is a complication that potentially occurs during TURP surgery. It is a water intoxication related to hyponatremia and acid‐based imbalance. This syndrome should be recognized early in order to prevent fatality. This pilot study employed a participatory action research combined with statistical analysis for validity and reliability testing. Twenty‐eight Indonesian urological nurses and one urologist medical doctor were engaged in this study. Informed consent was obtained before study outset. The study was entirely accomplished at Muhammadiyah Hospital I and II, Yogyakarta, Indonesia. Pearson's correlations test of each item was measured with correlation coefficient greater than 0·40 considered as evidence of satisfactory item convergence validity. The instrument reliability test was confirmed by Cronbach's α coefficients with score greater than 0·433 supposed as a reliable instrument. This study obtained a nursing instrument to assess TURP syndrome which involved 15 aspects as follows: disorientation, headaches, altered states of consciousness, visual disturbances, nausea and vomiting, hypertension, rhonchi sound, tachycardia, abnormal capillary refill‐time, tachypnea, hyponatremia, hyperkalemia, anaemia, increased urea and creatinine, and lower‐extremities oedema. A nursing instrument to assess TURP syndrome was established. Nevertheless, further investigation is required among patients who are suspected of having TURP syndrome to increase instrument accuracy.

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Section: Discussionsupporting

confidence: 49%

Section: Renal and Metabolic Disturbances A Natremiamentioning

confidence: 99%

Nursing assessment of TURP syndrome: a pilot study

Subrata

Istanti

Kesetyaningsih

2018

Int J of Uro Nursing

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“…10 Hemolysis has been described as a complication of TURP due to absorption of hypotonic fluids, which reduces the relative tonicity of the local microenvironment, leading to cellular lysis via osmotic shift. Hung et al 11 reported a case of a 72-year-old male with CKD who underwent TURP using distilled water, and became oliguric 24 h post-procedure. Although this patient was also started on hemodialysis for treatment of his AKI, he recovered adequate renal function for this to be discontinued after six sessions.…”

Section: Discussionmentioning

confidence: 99%

“…No renal biopsy was performed on their patient, however. 11 In a retrospective case series, Beal et al examined 49 patients who underwent TURP with spinal anesthesia, 24 who were exposed to distilled water, and 25 who were exposed to 1.5% glycine. Comparable reductions in hematocrit were noted in both groups, and free bilirubin concentration, which was used as a surrogate for hemolysis, was noted to be statistically higher in both groups.…”

Section: Discussionmentioning

confidence: 99%

Heme-pigment nephropathy after transurethral resection of prostate cancer

Kumar

Besharatian

Kobrin

et al. 2018

Journal of Onco-Nephrology

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Introduction: Transurethral resection of the prostate is one of the most common surgical procedures performed in men to relieve bladder outlet obstruction, most often due to benign prostatic hyperplasia. However, transurethral resection of the prostate may also be used in patients with metastatic prostate cancer who have bladder outlet obstruction. Acute kidney injury after transurethral resection of the prostate has been described and attributed to a variety of mechanisms, including acute tubular necrosis, rhabdomyolysis, and hemolysis with heme-pigment nephropathy. However, to our knowledge, no case of kidney biopsy-proven heme-pigment nephropathy due to hemolysis from a transurethral resection of the prostate procedure has been published to date. Case description: We describe a case of an 82-year-old man with metastatic prostate cancer who presented with severe oliguric renal failure 2 weeks after transurethral resection of the prostate for bladder outlet obstruction. Laboratory studies showed evidence of hemolysis, and a kidney biopsy showed heme-pigment cast nephropathy. Conclusions: We hypothesize that the patient's kidney injury was induced by hemolysis resulting from rapid absorption of hypotonic fluid administered during the transurethral resection of the prostate procedure. Patients with prostate cancer undergoing transurethral resection of the prostate for bladder outlet obstruction may experience severe complications related to rapid absorption of hypotonic fluid. Our case illustrates the importance of nephrology evaluation and kidney biopsy in patients with benign and malignant prostate conditions who experience post-transurethral resection of the prostate syndrome and acute kidney injury in order to better characterize these complications, and to develop preventative strategies for future cases.

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“…10 This effect is believed to be the cause of pulmonary and systemic hypertension when free hemoglobin is present in the circulation. 11 Hung et al 12 describe intravascular hemolysis after TURP with distilled water. Acute renal failure occurs in the setting of hemolysis, 13 and the possible culprits are attributed to either free-hemoglobin or stroma freed from destroyed RBC.…”

Section: Discussionmentioning

confidence: 99%

Urethral Injury During Potassium-Titanyl-Phosphate Laser Prostatectomy Complicated by Transurethral Resection Syndrome

Dilger¹,

Walsh²,

Warner³

et al. 2008

Anesthesia &Amp; Analgesia

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The green light potassium-titanyl-phosphate laser photoselective vaporization of the prostate is the latest modality for treatment of benign prostatic obstruction. Because of effective superficial tissue coagulation, intravascular absorption of fluid is minimal; therefore, development of transurethral resection syndrome is unlikely. To our knowledge, this is the first report of a patient undergoing photoselective vaporization of the prostate who developed full-blown transurethral resection syndrome because of intravascular absorption of sterile water. Absorption of hypotonic irrigant presumably occurred through the injury induced during insertion of the laser cystoscope.

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Acute renal failure directly caused by hemolysis associated with transurethral resection of the prostate

Cited by 9 publications

References 8 publications

Nursing assessment of TURP syndrome: a pilot study

Nursing assessment of TURP syndrome: a pilot study

Heme-pigment nephropathy after transurethral resection of prostate cancer

Urethral Injury During Potassium-Titanyl-Phosphate Laser Prostatectomy Complicated by Transurethral Resection Syndrome

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